Individual
MRS. EBONY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
501 W RAY RD STE 1-2, CHANDLER, AZ 85225-7284
(480) 296-2363
(480) 685-9875
Mailing address
137 E MARY LN, GILBERT, AZ 85295-1453
(210) 701-4806
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
AZSLP11463
AZ
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/15/2014
Last updated
08/27/2021
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